A strange form of dysphonia…

Abstract

A 40-year-old man, with no medical and surgical history apart from smoking, estimated at 15 pack-years, consulted for dysphonia associated with disabling snoring. The dysphonia had been present for 6 months and first occurred after "straining his voice". Nasolaryngeal fibroscoscopy (or fiber-optic endoscopy) revealed a left supraglottic submucosal swelling, displacing the ventricular band associated with immobile vocal cords. No mucosal lesion was detected. Computed tomography of the neck and chest, performed elsewhere, was not contributive. Panendoscopy revealed normal (E. Berta). mucosa with a firm submucosal mass that was not accessible to biopsy. Complementary MRI and transcervical microbiopsies were then performed ( Fig. 1A-D). Questions• Interpret the MRI?• Interpret histological sections?• What is the most likely diagnosis?• How would you complete the diagnostic and therapeutic management?http://dx.